High Blood Pressure and Cardiovascular Disease Mortality Risk Among U.S. Adults: The Third National Health and Nutrition Examination Survey Mortality Follow-up Study

Gu, Qiuping; Burt, Vicki L.; Paulose-Ram, Ryne; Yoon, Sarah; Gillum, Richard F.

doi:10.1016/j.annepidem.2007.11.013

Cited by 140 publications

(125 citation statements)

References 25 publications

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“…Our findings of an inverse association between birth weight and blood pressure are consistent with the results from a recent review (37). Elevated blood pressure represents a hallmark of the metabolic syndrome and is a significant independent risk factor of CVD mortality (38).…”

Section: Discussionsupporting

confidence: 81%

Born with low birth weight in rural Southern India: what are the metabolic consequences 20 years later?

Nicolaï¹,

Grunnet²,

Poulsen³

et al. 2012

European Journal of Endocrinology

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Objective: Low birth weight (LBW) is common in the Indian population and may represent an important predisposing factor for type 2 diabetes (T2D) and the metabolic syndrome. Intensive metabolic examinations in ethnic LBW Asian Indians have been almost exclusively performed in immigrants living outside India. Therefore, we aimed to study the metabolic impact of being born with LBW in a rural non-migrant Indian population. Subjects and methods: One hundred and seventeen non-migrant, young healthy men were recruited from a birth cohort in a rural part of south India. The subjects comprised 61 LBW and 56 normal birth weight (NBW) men, with NBW men acting as controls. Subjects underwent a hyperinsulinaemic euglycaemic clamp, i.v. and oral glucose tolerance tests and a dual-energy X-ray absorptiometry scan. The parents' anthropometric status and metabolic parameters were assessed. Results: Men with LBW were shorter (167G6.4 vs 172G6.0 cm, P!0.0001), lighter (51.9G9 vs 55.4G7 kg, PZ0.02) and had a reduced lean body mass (42.1G5.4 vs 45.0G4.5 kg, PZ0.002) compared with NBW controls. After adjustment for height and weight, the LBW subjects had increased diastolic blood pressure (77G6 vs 75G6 mmHg, PZ0.01). Five LBW subjects had impaired glucose tolerance. In vivo insulin secretion and peripheral insulin action were similar in both the groups. Mothers of the LBW subjects were 3 cm shorter than the control mothers. Conclusion: Only subtle features of the metabolic syndrome and changes in body composition among LBW rural Indians were found. Whether other factors such as urbanisation and ageing may unmask more severe metabolic abnormalities may require a long-term follow-up.

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Section: Discussionsupporting

confidence: 81%

Born with low birth weight in rural Southern India: what are the metabolic consequences 20 years later?

Nicolaï¹,

Grunnet²,

Poulsen³

et al. 2012

European Journal of Endocrinology

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“…Other studies failed to demonstrate a significant interaction between diabetes mellitus or HbA 1c and BP in the prediction of cardiovascular death, 36 a composite cardiovascular endpoint, 8,[37][38][39][40] stroke, 40 or coronary heart disease. 36,37 The sample size in these studies ranged from 4320 (see ref.…”

Section: Discussionmentioning

confidence: 98%

“…36) to 100%. 37 The covariables accounted for in the analyses included ethnicity, 37,39 sex, [36][37][38][39][40] age, [36][37][38][39][40] body mass index, 36,39,40 smoking, [36][37][38]40 alcohol intake, 40 physical activity, 40 education, 40 history of cardiovascular disease, 36,39 serum cholesterol, 36,37,39,40 or albuminuria. 37 Masked hypertension was associated with increased risk both in non-diabetic subjects and in patients with diabetes, without any significant interaction.…”

Section: Discussionmentioning

confidence: 99%

Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

Sehestedt

Hansen

et al. 2011

Hypertens Res

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It remains unknown whether diabetes and high blood pressure (BP) are simply additive risk factors for cardiovascular outcome or whether they act synergistically and potentiate one another. We performed 24-h ambulatory BP monitoring in 8494 subjects (mean age, 54.6 years; 47.0% women; 6.9% diabetic patients) enrolled in prospective population studies in 10 countries. In multivariable-adjusted Cox regression, we assessed the additive as opposed to the synergistic effects of BP and diabetes in relation to a composite cardiovascular endpoint by testing the significance of appropriate interaction terms. During 10.6 years (median follow-up), 1066 participants had a cardiovascular complication. Diabetes mellitus as well as the 24-h ambulatory BP were independent and powerful predictors of the composite cardiovascular endpoint. However, there was no synergistic interaction between diabetes and 24-h, daytime, or nighttime, systolic or diastolic ambulatory BP (P for interaction, 0.07pPp0.97). The only exception was a borderline synergistic effect between diabetes and daytime diastolic BP in relation to the composite cardiovascular endpoint (P¼0.04). In diabetic patients, with normotension as the reference group, the adjusted hazard ratios for the cardiovascular endpoint were 1.35 (95% confidence interval (CI), 0.87-2.11) for white-coat hypertension, 1.78 (95% CI, 1.22-2.60) for masked hypertension and 2.44 (95% CI, 1.92-3.11) for sustained hypertension. The hazard ratios for non-diabetic subjects were not different from those of diabetic patients (P-values for interaction, 0.09pPp0.72).In conclusion, in a large international population-based database, both diabetes mellitus and BP contributed equally to the risk of cardiovascular complications without evidence for a synergistic effect.

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“…2,3 Among blacks, hypertension develops earlier in life, is more severe, and causes more complications including stroke, heart disease, and end-stage renal disease. 1,4,5 Cardiovascular disease (CVD) accounts for 35% of excess overall mortality in blacks, largely because of hypertension. 6 Compared with whites, blacks are more likely to have hypertension, be aware of it, and be treated with antihypertensive medications, but less likely to achieve blood pressure (BP) control.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

et al. 2009

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BACKGROUND: Racial disparities in hypertension control contribute to higher rates of cardiovascular mortality among blacks. Patient-physician communication quality is associated with better health outcomes, including blood pressure (BP) control. Both race/ethnicity and BP control may adversely affect communication. OBJECTIVE:To determine whether being black and having poor BP control interact to adversely affect patient-physician communication more than either condition alone, a situation referred to as "double jeopardy." DESIGN, SETTINGS, AND PATIENTS:Cross-sectional study of enrollment data from a randomized controlled trial of interventions to enhance patient adherence to therapy for hypertension. Participants included 226 hypertensive patients and 39 physicians from 15 primary care practices in Baltimore, MD. MEASUREMENTS:Communication behaviors and visit length from coding of audiotapes. RESULTS:After controlling for patient and physician characteristics, blacks with uncontrolled BP have shorter visits (B=−3.9 min, p<0.01) with less biomedical (B=−24.0, p=0.05), psychosocial (B=−19.4, p< 0.01), and rapport-building (B=−19.5, p=0.01) statements than whites with controlled BP. Of all communication outcomes, blacks with uncontrolled BP are only in "double jeopardy" for a patient positive affect-coders give them lower ratings than all other patients. Blacks with controlled BP also experience shorter visits and less communication with physicians than whites with controlled BP. There are no significant communication differences between the visits of whites with uncontrolled versus controlled BP.CONCLUSIONS: This study reveals that patient race is associated with the quality of patient-physician communication to a greater extent than BP control. Interventions that improve patient-physician communication should be tested as a strategy to reduce racial disparities in hypertension care and outcomes.

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High Blood Pressure and Cardiovascular Disease Mortality Risk Among U.S. Adults: The Third National Health and Nutrition Examination Survey Mortality Follow-up Study

Cited by 140 publications

References 25 publications

Born with low birth weight in rural Southern India: what are the metabolic consequences 20 years later?

Born with low birth weight in rural Southern India: what are the metabolic consequences 20 years later?

Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

The Effect of Patient Race and Blood Pressure Control on Patient-Physician Communication

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